It would be impossible for aged care homes who spend just $7 a day on food for each resident to be able to provide a proper diet that the elderly need and deserve, celebrity chef Maggie Beer has told the Aged Care Royal Commission on the second day of hearings in Cairns today.
“It’s not possible because they [chefs] will have to use processed foods, frozen food, frozen vegetables, fish that is usually frozen and imported, not even Australian,” Ms Beer said in delivering evidence.
Ms Beer suggested $10.50 would be the minimum food budget to adequately feed aged care residents, as long as it was provided by trained and passionate cooks and chefs supported by providers and adequate staffing.
“It costs no more money to be able to do things from scratch if they have a garden and if they have processes in place that they can use the garden [to produce fruits and vegetables],” she said for example.
“So it is not just budget but you cannot do it without budget.”
The Royal Commission heard how Ms Beer established the Maggie Beer Foundation in 2014 in a bid to improve the food experiences of older Australians living in aged care.
The foundation has since trained 260 chefs working in aged care through its masterclasses that aim to develop cooking skills, build confidence and provide a positive environment for sharing ideas and knowledge.
She said on the final day of training, aged care CEO’s are invited to attend and see first-hand what type of food can be created “if they show leadership”.
The 2010 Senior Australian of the Year, Ms Beer said older Australians living in aged care deserved a well-rounded diet typified by food that takes into account smell, goodness, pleasure, and most importantly, flavour.
It was also important to create the feeling of home for residents through food by tapping into emotional cues that bring back fond memories, she added.
“It’s the thing that drives them. I feel it’s the one thing that is, if you like, that immediate satisfaction. It’s not just for the young to have that. It’s the thing that is left for them most but without the energy that comes from good food they don’t have the will or the physicality to be involved.”
On a personal level, Ms Beer recounted her aunt’s “terrible” experience in an aged care facility 50 years ago and how her rising profile gave her the opportunity to push for change.
“My aunt didn’t want to eat anything [and] lost all the weight because the food was without smell. It was institutionalised food in its most basic form and there is no room for institutionalised food.”
Ms Beer said many aged care providers were providing meals that are “cook chill”, food prepared and then cooled for reheating.
“Without the right budget for the right ingredients, you cannot make good food with bad ingredients.”
Ms Beer argued being a cook or chef in an aged care home was more complex than other settings yet adequate training was still lacking.
She said a lack of training, lack of respect and poor pay among cooks and chefs dominated systemic issues.
“It’s [more complex] because [chefs are] dealing with vulnerable people, so often in high care, the onset of dysphagia in so many, the inability to swallow that needs a totally different way of cooking in terms of food that those people can cope with. So it’s specialised. And there is no training.”
She told the hearing feedback received from cooks and chefs attending masterclasses over the past few years had been overwhelmingly positive and echoed an evaluation from Flinders University of the foundation’s impact.
The main impediments to chefs implementing measures highlighted during training commonly include budget, training and the resistance of staff unwilling to adopt new practices.
“I have piles of letters and emails saying how they went back and they made change. They threw out packaged foods. The made stocks from scratch. They used fresh vegetables.”
Counsel assisting, Ms Brooke Hutchins, asked Ms Beer about the foundation’s latest move into providing online skills based training and what the initial 11 modules aimed to achieve.
Ms Beer said some of the pilot modules cover basic cooking skills, such as adding butter to a hot pan to enhance flavour and choosing ingredients which benefit most from pan frying, as well as using fresh herbs from the garden.
The importance of flavour and visual appearance of a meal could not be undersold, Ms Beer stressed.
“Flavour is everything. Flavour with aroma along with goodness, the nutrition, will give the pleasure and it can be done but there’s a lot of work to do.”
In a statement submitted to the Royal Commission earlier, Ms Beer revealed common complaints she receives about the state of food in aged care surround choice, quality, lack of flavour, colour, texture, variety, nutritional contents, smell, lack of fresh and seasonal produce, and the extensive use of packaged and pre-packaged foods.
“It’s a terrible thing. These letters are often so personal and deal with a family member or the person themselves in the aged care home and it just breaks your heart because it doesn’t have to be like that. It should never be like that. We have a responsibility to give a good way of life for those in aged care and in the community, those elderly living on their own. And to change it we need everyone involved.”
Ms Beer said 2014 guidelines stipulating “meals of adequate quality and quantity” were not good enough.
“Adequate is not enough for people who don’t have a choice, who have had hard lives and we have a responsibility to look after and give them pleasure as well as health. There’s nothing there about emotional wellbeing, the quality of life they deserve.”
Pressed on the adequacy of the new Aged Care Quality Standards, which came into effect in July, she said they fell short of the mark.
“What I would have liked to see in the new standards is a system to gather residents’ feedback on their food experiences and that requirement to meet a satisfactory level for accreditation.”
Ms Beer said proper food accreditation standards in aged care were essential, including the input of dieticians, nutritionists and other professionals placing an emphasis on flavour, appetite, pleasure and wellbeing.
“Nutrition is not enough on its own. It’s absolutely essential but it’s not enough.”
Ms Beer told the hearing more research was now required to ensure aged care residents attained dignity and choice.
In conclusion, she outlined several recommendations for the Aged Care Royal Commission to take on board, with key issues concerning funding for more research into the design of food in aged care and the relationship between food and physical and emotional wellbeing, raising the status of cooks and chefs working in aged care and improving wages, and boosting training.